Erectile dysfunction, also called impotence, means that a man's penis doesn't get hard enough to have intercourse. The man cannot get or maintain an erection (Erectile dysfunction is not the same as premature ejaculation, retarded ejaculation or infertility.)

The major causes of erectile dysfunction include:

Vascular (blood vessel) disease - Because erections are caused by the buildup of blood in the shaft of the penis, poor blood flow in the penis can result in problems with erections. Damage to blood vessels can be caused by hardening of the arteries (atherosclerosis) or damage to blood vessels from trauma. Vascular disease is believed to be the most common medical cause of erectile dysfunction.

Nerve damage (neuropathy) - Nerves must be working normally for a man to be able to get and keep an erection. Nerve damage can result from diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.

Psychological factors - Sexual problems sometimes are caused by psychological issues such as depression, anxiety, guilt or fear. At one time, psychological factors were thought to be the major cause of erectile dysfunction. Doctors now know that physical factors are present in most men. However, embarrassment or "performance anxiety" can make a physical problem worse. Erectile dysfunction caused only by psychological causes is found most commonly in young men.

Hormonal problems - Abnormal levels of certain hormones, such as testosterone, thyroid hormone and a pituitary hormone known as prolactin, can interfere with erections and sex drive (libido). This is an uncommon cause of erectile dysfunction.

Symptoms A man with erectile dysfunction has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity by preventing penetration during intercourse.

Erectile dysfunction can occur suddenly or gradually. Some men slowly lose the firmness of their erections or how long the erections last. In other men, especially those whose impotence is largely caused by psychological factors, the problem may occur unpredictably and can improve at any time. Despite their difficulties with erections, men with impotence often continue to have normal orgasm and ejaculation.

Your doctor will perform a general physical examination, including an examination of your penis and testes, to look for evidence of underlying medical problems. Your blood may be tested for blood sugar (to rule out diabetes), cholesterol and levels of certain hormones.

Occasionally, a doctor may order additional tests, such as a nocturnal penile tumescence study. This is a way to assess how often you get erections while you sleep. A Doppler ultrasound of the blood vessels in the penis is another test that will occasionally show a cause for poor erections.

Treatment

There are many effective treatments for erectile dysfunction. Currently, the most popular option is sildenafil (Viagra), which is taken in pill form on an empty stomach about one hour before sexual activity. It works in approximately 70 percent of men. (It is less effective in men with neurological causes of erectile dysfunction such as prostate surgery, diabetes and spinal-cord injury.) Sildenafil can cause minor side effects such as flushing and headache, but it has been shown to be safe in most men, including those with heart disease. Psychological therapy such as counseling, behavioral therapy or couples' therapy can be effective in men whose impotence is caused primarily by psychological factors.

Yoga considers that most diseases are due to insufficient life force, either in the body as a whole, or a blockage of life force to one part of the body.

When the whole body has lowered life force, the result is a lowered vitality level, poor health and susceptibility to infection Yoga provides one of the best means of self-improvement and attaining one's full potential

KHANDASANA

Kanda means a bulbous root, a knot. The Kundalini sleeps above kanda (the place near the navel where the nadis unite and separate). It gives Mukti (emancipation) to the yogins and bondage to the fools. He who knows her knows yoga.

Sit on the floor with the legs stretched straight in front. Bend the knees, widen the thighs, bring the feet towards the trunk until the heels are close to the perineum and keep the knees on the floor. The position is similar to Baddhakonasana.

Hold the right foot with the right palm and the left foot with the left palm.

With the help of the hands, draw the feet up towards the trunk, invert the ankle, pull the knees and thighs, and place the heels and the outer sides of the feet against the navel and chest. To start with the feet are likely to slip down. Practice the pose for a few weeks, holding the feet firmly against the chest.

Release the hands, and either stretch the arms straight and rest the back of the hands on the knees or join the palms in front of the chest. Keep the back erect and stay I n the pose for about 30 seconds with deep breathing.

Advanced pupils may raise the hands, palms together, above the head. Then try to join the palms behind the back and balance: this is the most difficult part of the asana.

Hold the feet with the hands, lower them to the floor and rest.

As the pelvic and other joints of the legs are rotated it takes a long time to master the pose.

Effect

Every muscle below the navel is exercised. The pose cures stiffness in the hip, knee and ankle joints. It restores sexual energy and controls sexual desires.

The asana also exercises the Svadhisthana Chakra (the hypo gastric plexus) and the Manipuraka Chakra (the solar plexus), thus helping proper digestion.

This article has been written by Dr. R. Nagarathna,
Dean, Division of Yoga & Life-sciences, SVYASA
This article is published online courtesywww.vyasa.org and Arogyadhama

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